title: High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner--the Diabetes Research in Children Network (DirecNet) experience.
abstract: BACKGROUND
  The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk.
  
  
  OBJECTIVE
  We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children.
  
  
  METHODS
  222 children (4-9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner.
  
  
  RESULTS
  205 children (92.3%), mean age 7 ± 1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner.
  
  
  CONCLUSIONS
  Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Center for Interdisciplinary Brain Sciences Research, Stanford, CA, USA.
authors.forename: Naama
authors.initials: N
authors.lastname: Barnea-Goraly
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Weinzimer
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Matt J
authors.initials: MJ
authors.lastname: Marzelli
authors.forename: Paul K
authors.initials: PK
authors.lastname: Mazaika
authors.forename: Tandy
authors.initials: T
authors.lastname: Aye
authors.forename: Neil H
authors.initials: NH
authors.lastname: White
authors.forename: Eva
authors.initials: E
authors.lastname: Tsalikian
authors.forename: Larry
authors.initials: L
authors.lastname: Fox
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Peiyao
authors.initials: P
authors.lastname: Cheng
authors.forename: Allan L
authors.initials: AL
authors.lastname: Reiss
mesh_terms: D000293:Adolescent; D016477:Artifacts; D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D003887:Desensitization, Psychologic / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D009038:Motion; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States